Section IV Contents

Distribution of Specialty

Demographics

Education

Practice Characteristics

Specialties and Services

The psychiatry specialties included in Section IV consist of physicians with a specialty psychiatry and child psychiatry. General psychiatry made up the majority of psychiatrists at around 90.5%, while 9.5% reported child psychiatry as a specialty.

As shown in Table 4.2, the largest proportion of psychiatrists completed their medical education in another US state (29.7%), followed by another country (28.6%), and Indiana (22.3%). Just under half of psychiatrists (45.9%) completed their residency training in another US state, followed by 29.0% who completed residency training in Indiana. Only 0.4% of psychiatrists reported completing their residency training in another country.  

Table 4.3 describes the reported practice settings for psychiatrists serving Indiana residents. Most psychiatrists (n=765; 97.8%) reported a primary practice setting, while 226 (28.9%) reported a secondary practice setting and 67 (8.6%) reported a tertiary setting. Hospital-inpatient was the most frequently reported primary practice setting at 17.6% of psychiatrists who reported this setting, followed by 15.0% who reported a telemedicine setting. Psychiatrists reported a telemedicine setting more frequently than Indiana’s total physician workforce (8.7%) and primary care physicians (9.5%). Office/clinic-single specialty group was the third most frequently reported primary practice setting at 12.8% of respondents. Additional information about secondary and tertiary practice settings is included in Table 4.3 below.

More than a third of (38.0%) of psychiatrists reported spending at least 37 hours per week in patient care at their primary practice. Psychiatrists reported spending fewer hours per week in patient care at secondary and tertiary practices. It was most frequently reported that psychiatrists spent an average of 9-12 hours per week in patient care at their secondary practice (n=48; 6.1%) and 1-4 hours per week in patient care at their tertiary practice (n=20; 2.6%). Additional details about time psychiatrists spend in patient care can be found in Table 4.4 below.

Most psychiatrists (79.7%) reported no planned employment changes for the next two years. Those were followed by 6.1% who planned to decrease hours, 5.4% who planned to increase hours, and 1.8% who planned to retire.

Table 4.6 describes the reported characteristics of patient panels for psychiatrists. When reporting on their primary practice, psychiatrists most frequently reported that they do not offer a sliding fee scale (21.0%). However, 9.5% of psychiatrists reported that >0%-5% of their patient panel is on a sliding fee scale followed by 5.4% who reported that around 6-10% of their patient panel is on a sliding fee scale. At the same time, 61.6% of psychiatrists reported accepting Indiana Medicaid at their primary practice. Compared to all physicians (8.3%) and PCPs (11.2%), Indiana psychiatrists (21.5%) were more likely to report that greater than 50% of their patient panel were Medicaid recipients at their primary practice.

As shown in Table 4.7, the majority of psychiatrists reported that they were accepting new Indiana Medicaid patients (61.9%). Of those who were not accepting new Indiana Medicaid patients, the most frequently reported barriers were policies of practice, practicing at a government facility, and reimbursement rates.

Psychiatrists reported providing telemedicine services to Indiana residents (n=647; 82.7%) more frequently than PCPs (71.1%), (Table 3.8) and all physicians combined (61.8%), (Table 2.8). The majority of those providing telemedicine services reported a psychiatry specialty at 90.1%.  

In subsequent tables, it should be noted that psychiatrists were able to report more than one service they provide and populations they serve. Because of this the total count of psychiatrists providing each service or serving each population will be reported by specialty.

Of the 782 physicians who reported a psychiatry or child psychiatry specialty, more than half (n=408; 52.2%) reported providing at least one addiction service. Psychiatrists most frequently reported providing addiction counseling (n=316), followed by screening for addiction (n=219). The majority of those providing addiction services reported a psychiatry specialty (94.6%)

Of the 782 psychiatrists actively practicing in Indiana, a total of 64 (8.2%) reported providing at least one obstetric service. The most frequently reported services were treatment for OUD-affected pregnancy (n=47), pre-natal services (n=18), and post-natal services (n=17). The majority of those providing obstetric services reported a psychiatry specialty (95.3%).

Nearly half of psychiatrists (n=358; 45.8%) reported providing services to at least one pediatric population. A total of 355 psychiatrists reported providing services to adolescents ages 11-19 and 230 reported providing services to children ages 2-10. Many psychiatrists serving pediatric populations reported a psychiatry specialty (79.3%), but a significant proportion reported child psychiatry (20.7%) as a specialty.  

Nearly all (n=737; 94.2%) psychiatrists reported serving at least one population of interest. The adult population was most frequently reported (n=704), followed by geriatric (n=421), individuals with disabilities (n=297), and individuals in recovery (n=297). Most reported a psychiatry specialty (92.7%), while 7.3% reported child psychiatry as a specialty.